South African Theological Seminary

Conference − May, 2011

What is “Play Therapy”?

“. . . a dynamic interpersonal relationship

Play Therapy between a child (or person of any age) and
a therapist trained in play therapy
with Sexually procedures who provides selected play
materials and facilitates the development of
Abused Children a safe relationship for the child (or person
of any age) to fully express and explore self
(feelings, thoughts, experiences, and
Daniel S. Sweeney, Ph.D. behaviors) through the child’s natural
NW Center for Play Therapy Studies medium of communication, play.”
George Fox University (Landreth, 2002)

The Play Therapy

Relationship is Focused On: Children’s Play Will Reveal

Person rather than Problem   What they have experienced.

Present rather than Past   Their feelings or reactions
Feelings rather than Thoughts/Acts about this.
Understanding rather than Explaining
  What they need in their lives.
Accepting rather than Correcting
Child’s Direction rather than Therapist’s’   Their self-image.
Instruction   Their image of others.
Child’s Wisdom rather than Therapist’s   Their image of God.
Knowledge
(Landreth, 2002)

Play Therapy Rules - Don’t Praise vs. Encouragement

1.  Don't criticize any behavior. PRAISE is primarily given to children when they do
a task well and usually involves an evaluative
2.  Don't praise the child. response. Because of this, children can learn to
3.  Don't ask leading questions. not trust in their own ability to evaluate and
4.  Don't allow interruptions of the session. learn to depend on other's evaluations of them.
Children can easily misinterpret their value as
5.  Don't offer information or teach.
persons, their "goodness" or "badness",
6.  Don't preach. according to the amount of praise statements
7.  Don't initiate new activities. received or not received. The child can come to
8.  Don't be passive or quiet. believe: "Only when I receive praise am I a
valuable person, and if I don't receive praise
that must mean I am not valuable."
(Landreth, 2002)

Daniel S. Sweeney, Ph.D., LPC, LMFT, RPT-S ©Copyright 2011. All rights reserved.
NW Center for Play Therapy Studies / George Fox University Unauthorized duplication prohibited.
 South African Theological Seminary
Conference − May, 2011

Praise vs. Encouragement Play Therapy Rules - Do

ENCOURAGEMENT implies faith in the child as 1.  Do set the stage.

he is, not in his potentiality. The emphasis 2.  Do let the child lead.
is on the child's actions, not on the child's
worth. Encouraging statements build on 3.  Do track behavior.
the positiveness of the action and the 4.  Do reflect the child's feelings.
effort — and can always be given; when a 5.  Do set limits.
child attempts a task, fails at a task, or
6.  Do salute the child's power and effort.
accomplishes a task. A child needs
encouragement as a plant needs water. 7.  Do join in the play as a follower.
8.  Do be verbally active.

(Landreth, 2002)

Other characteristics of
Therapeutic Responses . . .
therapeutic responses
 Are brief and interactive
  Avoid asking questions
 Allow child to lead
 Are personalized   Help child to go on – do not
 Avoid: “David really likes hitting interrupt natural flow of child’s
that bop bag.” play
 Use: “You really like hitting that   Are nonevaluative
bop bag.”
 Touch feeling (match child’s affective level)
  Do not praise!
  Build self-esteem

Therapists/Adults should
Facilitative Responses communicate to children . . .

  Was the response freeing to the

child?
  I’m here
  Did the response facilitate decision
making or responsibility?
  I hear you
  Was spontaneity or creativity
facilitated?
  I understand
  Did the child feel understood?   I care
(Landreth, 2002)

Daniel S. Sweeney, Ph.D., LPC, LMFT, RPT-S ©Copyright 2011. All rights reserved.
NW Center for Play Therapy Studies / George Fox University Unauthorized duplication prohibited.

Tracking
  follows, or tracks, with eyes & words
  occurs from the therapist’s chair
  labels child’s feelings
  identifies child’s behavior; goal of
misbehavior
  accepts feelings, regardless of actions
  responds to child’s meaning
Facilitative Responses
  conveying understanding
  “You’re cooking.”
  freeing the child
  “In here, you can spell it anyway
you’d like to.”
  setting limits
  ACT limit setting model
Summary – Therapeutic Responses
  Avoid questions
  Be succinct
  Track behavior
  Reflect feelings
  Match the child’s affective
level
  Facilitate decision-making
  Encourage – don’t praise
Daniel S. Sweeney, Ph.D., LPC, LMFT, RPT-S
NW Center for Play Therapy Studies / George Fox University
South African Theological Seminary
Conference − May, 2011
Facilitative Responses
  tracking behavior
  “now you’re pouring sand...”
  reflecting feelings
  “you’re really mad at the alligator...”
  reflecting content
  “those two are fighting...”
  esteem building / encouragement /
focusing on strengths
  “you decided... you’ve got a plan...”
Facilitative Responses
  facilitating decision making &
responsibility
  “In here, you can decide.”
  facilitating spontaneity & creativity
  “It can be whatever you’d like it
to be.”
  enlarging the meaning
  “It can be scary to be all alone.”
Therapeutic Limits
(Sweeney & Landreth, 2009)
Since boundaries have previously been determined, the
play therapist can be consistent and thus predictable
in setting limits. This consistency and predictability
help the child to feel safe. It is within this structure
that the feeling of permissiveness is more important
than actual permissiveness. When limit setting
becomes necessary, the child's desire to break the
limit is always the primary focus of attention because
the child-centered play therapist is dealing with
intrinsic variables related to motivation, perception of
self, independence, need for acceptance, and the
working out of a relationship with a significant person.
©Copyright 2011. All rights reserved.
Unauthorized duplication prohibited.
 South African Theological Seminary
Conference − May, 2011

What to Limit What to Limit

  Harmful behavior
  Play therapy materials
  The child should not harm self
  Toys belong in the playroom
  The therapist is not to be harmed
  Toys are not to be deliberately broken
  Other children are not to be harmed
  Other behaviors
  Behavior disruptive to therapy routine
  Socially unacceptable behavior
  Leaving the playroom before end of
session   Inappropriate displays of affection
  Refusing to leave the playroom at end
of session

Therapeutic Limit Setting

Therapeutic Limit Setting - A.C.T.
A.C.T.
1.  A - Acknowledge the child's   The “ultimate” limit
feelings, wishes, and   only if ACT doesn’t work
wants   add the consequence

2.  C - Communicate the limit “I know you’re mad and you want to shoot
3.  T - Target acceptable me, but I’m not for shooting, the bop bag
is for shooting. If you choose to
alternatives (Landreth, 2002) shoot me again, then you choose
not to play with the dart gun
I know you’d like to shoot me, but I’m not anymore today.”
for shooting, the bop bag is for shooting.

What do Traumatized Children

Play of Traumatized Clients
Learn in Play Therapy? Reenactment vs. Retraumatizing

  Learn that the world can be safe, consistent &

predictable Reenactment Play
  Learn that feelings (both positive & negative) are   Leads to mastery
acceptable   Client feels free to express emotion
  Develop the capacity to trust and attach with other   Client feels in control
persons.
  Learn to be creative & resourceful in confronting   Satisfactory conclusion
problems Retraumatizing Play
  Develop a greater capacity to cope   Fails to provide resolution
  Experience behaviors and feelings of control/mastery   Creates rather than relieves anxiety
  Develop an internal source of evaluation   Magnifies feelings of helplessness
  Learn to be more self-directed, responsible &   May need to be interrupted
autonomous
  Develop an enhanced sense of self & become more
self-accepting (adapted from Landreth, 2002)

Daniel S. Sweeney, Ph.D., LPC, LMFT, RPT-S ©Copyright 2011. All rights reserved.
NW Center for Play Therapy Studies / George Fox University Unauthorized duplication prohibited.

Characteristics of Posttraumatic Play
  Compulsive repetition
  Unconscious link between the
play and the traumatic event
  Literalness of play with simple
defenses
  Failure to relieve anxiety quickly
  Occurs across wide age range
  Has varying lag time prior to its
development
Traumatized Child’s Expression
  In play, children can slowly assimilate
traumatic experiences by reliving them
with appropriate release of affect.
  Children deal with stress and traumas by
playing out similar situations and
gradually achieving mastery over them.
  In play, the child is in control of the
events and there is less anxiety because
it is just pretend.
Process of Expressive Therapy
with Traumatized Clients
  As previously noted, it is my goal to
provide clients with a safe, reparative &
relational experience.
  This takes priority over a focus on insight
and/or cognitive restructuring.
  My role is therapeutic, not investigative –
to be fellow sojourner on the journey & a
witness to the story.
  The need for safety extends beyond the
therapeutic experience. There may be a
need to work with family, school, etc.
Daniel S. Sweeney, Ph.D., LPC, LMFT, RPT-S
NW Center for Play Therapy Studies / George Fox University
South African Theological Seminary
Conference − May, 2011
Characteristics of Posttraumatic Play
  Carrying power to nontraumatized
clients
  Possibility of therapeutically
retracing posttraumatic play to an
earlier trauma
  Can be dangerous, since prolonged
posttraumatic play may create more
terror than was consciously there
when the play started
Process of Play Therapy with
Traumatized Children
  Mere re-enactment of trauma in the play therapy
process – without movement towards resolution is
not helpful, and may be dangerous.
  The play therapy process needs to be both
facilitated and monitored. Traumatic play may
need to be interrupted.
  This interruption, if necessary, should work
towards the client maintaining power and control.
  The goal of play therapy is to help the child
process the trauma – verbally or nonverbally.
  The meaning of the trauma to the child is not as
important as processing it so that it can become
tolerable and manageable.
Techniques?
I am not opposed to techniques.
  However, therapists should ask
themselves three questions:
1)  Is this technique developmentally
appropriate?
2)  Does this technique have a theoretical
basis?
3)  Does my use of this technique have specific
therapeutic intent?
©Copyright 2011. All rights reserved.
Unauthorized duplication prohibited.
 South African Theological Seminary
Conference − May, 2011

Techniques?
  We need to acknowledge that theory
Daniel S. Sweeney, Ph.D., LPC, LMFT, RPT-S
alone is inadequate, and that in fact,
theory without technique is mere Director, NW Center for Play Therapy Studies
philosophy Graduate Department of Counseling
  At the same time, we need to recognize George Fox University
that techniques alone are inadequate, 12753 S.W. 68th Avenue
and that in fact, techniques without Portland, Oregon 97223
theory is potentially reckless and dsweeney@georgefox.edu
dangerous www.nwplaytherapy.org

Daniel S. Sweeney, Ph.D., LPC, LMFT, RPT-S ©Copyright 2011. All rights reserved.
NW Center for Play Therapy Studies / George Fox University Unauthorized duplication prohibited.